Page 18 - Effective healthcare cost containment policies Using the Netherlands as a case study - Niek W. Stadhouders
P. 18

Chapter 1
attaining the spending limit to health insurers
as purchasers. Purchasers are responsible for
reducing costs while maximising health
outcomes, i.e. increasing efficiency. In the
Netherlands, managed competition incentivises
insurers to selectively contract high-quality,
low-cost providers, thereby improving quality
while containing costs. Strategic purchasing
incentivises providers to maximise
performance and minimise costs. Providers can
attain these aims by prioritizing high-value care
and stimulating innovations that improve
quality. These quality improvements spawn
from innovative health professionals
responding to wishes and needs of patients. One
movement to further improve quality is person-
centred care (PCC), which stipulates the
importance of personal values and shared
decision making. On the other hand, health
professionals could use rationing to reduce
ineffective care, e.g. waste and inefficiencies, when faced with budget constraints. These interactions show that in a well-functioning system, efficiency gains are stimulated at all levels, ensuring cost containment while improving health outcomes.
  This thesis focuses on macro-level mechanisms of effective and efficient cost containment in the Dutch healthcare system. The focus on the macro level excludes cost containment policies and quality improvement strategies at the level of the provider and caregiver, e.g. hospital cost-saving strategies, quality improvement programs, prioritization, etcetera. Instead, focus is on the role of governments and purchasers in containing costs while stimulating quality improvements. This thesis contains four macro-level themes, displayed in figure 1.3:
1.6. Aims of this thesis
1) Effective cost containment policies at the government level;
2) The relation between cost containment and health outcomes at the macro level; 3) The role of purchasing in improving quality and containing costs;
10 4) Structural hospital characteristics associated with performance.








































































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